Abstract
BackgroundTo evaluate the prognostic value of axillary lymph node ratio (LNR) as compared to the number of involved nodes (pN stage) in patients with axillary lymph node-positive breast cancer treated with mastectomy without radiation.MethodsWe performed a retrospective analysis of the clinical data of patients with stage II-III node-positive breast cancer (N=1068) between 1998 and 2007. Locoregional recurrence-free survival (LRFS) and overall survival (OS) were compared based on the LNR and pN staging.ResultsA total of 780 cases were classified as pN1, 183 as pN2, and 105 as pN3. With respect to LNR, 690 cases had a LNR from 0.01-0.20, 269 cases a LNR from 0.21-0.65, and 109 cases a LNR > 0.65. The median follow-up time was 62 months. Univariate analysis showed that both LNR and pN stage were prognostic factors of LRFS and OS (p<0.05). Multivariate analysis indicated that LNR was an independent prognostic factor of LRFS and OS (p<0.05). pN stage had no significant effect on LRFS or OS (p>0.05). In subgroup analysis, the LNR identified groups of patients with different survival rates based on pN stage.ConclusionsLNR is superior to pN staging as a prognostic factor in lymph node-positive breast cancer after mastectomy, and should be used as one of the indications for adjuvant radiation therapy.
Highlights
Studies have shown that radiation therapy improves locoregional control of axillary lymph node-positive breast cancer, and thereby benefits survival [1,2,3]
We explored the prognostic value of lymph node ratio (LNR) in stage II-III nodepositive breast cancer patients without radiotherapy after mastectomy, and demonstrated that the LNR can better predict tumor recurrence and mortality
Our study suggests that the LNR is an independent prognostic factor of Locoregional recurrence-free survival (LRFS) and overall survival (OS), and pN staging lost significance when LNR was included in the multivariate analysis
Summary
Studies have shown that radiation therapy improves locoregional control of axillary lymph node-positive breast cancer, and thereby benefits survival [1,2,3]. The reliability of the LNR in predicting the prognosis in patients with greater than 3 positive nodes has rarely been addressed. In this retrospectively study, we compared the prognostic values of the LNR and number of involved nodes (pN) staging in 1068 patients with axillary lymph node-positive breast cancer without radiation therapy after mastectomy to Characteristic. To evaluate the prognostic value of axillary lymph node ratio (LNR) as compared to the number of involved nodes (pN stage) in patients with axillary lymph node-positive breast cancer treated with mastectomy without radiation
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